Find out more about our project at the Child Care History Network conference – Exeter, 3 October 2014

Today I am excited to announce that I will be giving a talk about our Unexplored Riches in Medical History project at this year’s Child Care History Network conference. The theme of the 2014 conference will be Healing the Wounds of Childhood – the Medical and Psychological Care of Children: Historical and Current Perspectives, and it will be held at the Buckerell Lodge Hotel in Exeter on 3 October 2014.

Click here for the conference website, where you can find the conference programme and details of how to book your place.

Children and staff at St Denys’ Home, Clitheroe, Lancashire, 1919

For my talk I’ll be discussing the Unexplored Riches in Medical History project in more detail. As we’re coming closer to the end of the project, it’ll be a great chance to look at what we’ve achieved so far and what medical information has been unearthed in the archive of The Children’s Society. I’m looking forward to sharing some of the great resources and stories we have here in our archive.

Alongside myself, there will be speakers covering various aspects of the history of children’s health and healthcare. This includes keynote speaker John Stewart, Emeritus Professor of Health History at Glasgow Caledonian University, who will be talking about the history of child guidance.

For more information and to book a place, please click here.

Humidification: water in the archive… on purpose

Today, we have a guest post written by one of our Project Conservators, Rebecca Regan.


During this project the conservators frequently come across severely crumpled or tightly folded documents within the children’s case files. Sometimes the documents have been squashed in this shape for over a hundred years. They need to be flattened so that they can be read by researchers and archivists. Documents which have to be repaired are also flattened first as this makes the repair process quicker, simpler and more effective.

Many of the documents are very fragile and brittle so this flattening process needs to be done slowly in order to prevent further damage. One of our most commonly used methods is called ‘humidification’. This entails placing the documents in an enclosed container, raising the moisture levels of the air inside the container slightly, in a controlled way, and waiting for the documents to relax sufficiently before unfolding and flattening any distortions.

Trays of documents being humidified

Trays of documents being humidified

Close-up showing the fine water vapour entering the humidification tray

Close-up showing the fine water vapour entering the humidification tray

The opened documents are then allowed to dry out completely while under pressure. Here you can see this being achieved using a traditional nipping press:

Humidified documents being pressed

The documents in the press are protected from surface damage by being sandwiched between layers of heavyweight blotting paper and a special inert plastic material which prevents the damp documents from sticking to the blotting paper.

This document was found wedged at the bottom of an envelope. It was extremely brittle and hard and impossible to unfold even slightly:

Crumpled document at bottom of envelope

Crumpled document removed from envelope

Here is the same document after humidification and pressing.

The once-crumpled document after humidification and pressing

It turned out to be a foster mother’s note about the child in her care. She describes her as a nice girl who is fond of her foster sister.

This photograph shows what can happen if the humidification process is omitted. At some point in the past, these fragile, brittle documents were forced flat. Unfortunately the resulting severe damage is only too evident.

Historical damage to brittle case file

In contrast, here is a case file, after conservation treatment during this current project, where all the brittle documents were humidified before pressing:

Brittle case file after conservation

The case file is now stabilised and easy to handle and read. It has become once more a useful and interesting historical resource.

Remembering the First World War

Today marks 100 years since Britain declared war on Germany and the First World War began.

The next four years will be a time to remember and reflect on the war and all those it affected.

Thomas, who was in the care of The Children's Society and later joined up to fight in the First World War, photo dated 1915

People like Thomas, who had entered the care of The Children’s Society (then known as the Waifs and Strays Society) around the age of six. He lived in the Rochdale Home for Boys and left the home in 1903, when he was around 16 years old. Like so many others, Thomas joined the army and went to fight in the First World War. The above photo of Thomas was taken in 1915.

As well as those at the front, the First World War affected those at home, and the Waifs and Strays Society saw many more children coming into care as a result.

We’ll be discussing some of the impacts of the war on the Waifs and Strays Society later in the week, so watch this space.

Making connections at the Society for the Social History of Medicine Conference 2014

Things are rather busy here at The Children’s Society Archive, as we’ve just returned from attending the Society for the Social History of Medicine’s 2014 conference. The theme for this year’s conference was Disease, Health and the State. It was held at St Anne’s College in Oxford over three days, and it hosted a multitude of speakers and attendees from across the world, all of whom had an interest in medical history.

St Anne's College, Oxford

Myself and the head of The Children’s Society Archive, Ian Wakeling, attended to run a stand in the conference marketplace. On our stand we had lots of information about the Unexplored Riches in Medical History project, including some facsimile case files and some posts from this blog that I’d printed out. See the stand and a few of our leaflets below.

Janine and Ian at The Children's Society Archive stand

Some of leaflets we took to the conference

It was my first time running a stand at a conference and I have to say that I really enjoyed it. Our aim was to promote The Children’s Society Archive and its wealth of medical information to the conference attendees. This was a big success. We spoke to a lot of people, most of whom hadn’t heard of The Children’s Society before and certainly wouldn’t have realised how useful our archive is for medical history research. They all seemed to be pleasantly surprised!

Janine talking to conference attendees

Not only were we able to give out our details to lots of people who were interested in the archive for research (for themselves or for their students, colleagues and friends), but we were also able to discuss people’s research interests, which were fascinating. It was really interesting to hear about all the research into medical history that’s going on, and to discuss how The Children’s Society archive collection can help.

I hadn’t quite realised, until I started discussing it, what a broad range of medical topics our archive covers. To help me write this blog post, while at the conference I was jotting down the subjects of all the conversations I had with attendees. It turns out that my list is so long that there’s no way I can put it all down here; instead, here’s just a highlight of some of the interesting topics we were talking about:

  • Nursing
  • Convalescent homes
  • Mental health
  • Hygiene
  • Foster care
  • Institutional healthcare
  • Rickets
  • Phototherapy
  • Diabetes
  • Deafness
  • Drug use
  • Funding for medical treatments

Not to mention, there were many times where we discussed how The Children’s Society started and how it got to where it is now, including the whole range of records it created during that time, from children’s case files to records from the individual children’s homes.

I could go on for a lot longer, but I’ll leave it here to say that Ian and I are both really glad that we went along. It was great to talk to medical historians about their research and introduce them to an archive that they may never have considered using before. Thanks to the conference organisers for a great event!

Conference attendees enjoying the sunshine

More information about the conference can be found on the 2014 conference website.

The website of the Society for the Social History of Medicine can be found here:

Sea air and tuberculosis (TB beside the seaside)

Today we have a guest post written by one of our project volunteers, George Cooban.


It’s the time of year when lots of us go to the seaside. The case files tell us that many of the children in the care of The Children’s Society in the late-19th and early-20th centuries also visited the coast. But, unlike today, it was often for medical reasons, rather than a holiday.

Previous posts on this blog have highlighted cases where various health conditions led to children spending time by the sea. The coastal convalescent homes run by The Children’s Society at Hurstpierpoint and Broadstairs, established to facilitate the care of sick children sent there, have also been researched in detail. However, I was keen to find out what the case files can tell us about the thinking behind this formerly commonplace practice.

Photograph of matron, staff and children outside 'Coronation Cottage', St David's Home, Broadstairs, Kent, c1912

Tuberculosis features very prominently in the case files, and the medical rationale behind the way it was dealt with is often quite clearly recorded. Therefore I decided to focus on cases relating to this condition in this blog post.


One thing we notice when examining many of these case files is that seaside convalescent homes were viewed as a means of preventing tuberculosis. (So not all the children who stayed at them were, strictly speaking, convalescent). This is illustrated by reports such as this one, dated 19 June 1910.

“There is a delicate girl aged 13, May [surname], who has been [at the Leamington Home for Girls] for many years, but has to be sent annually to the sea for her health. She probably has a tendency to tuberculosis, but no disease has developed owing to care. She now looks well having just returned from the sea. As she is now at a critical growing and developing age, it would be desirable to move her if possible to Felixstowe before winter for the next two or three years before she goes out. Leamington is relaxing and she needs bracing sea air.”

Another case file contains a medical certificate, written on 7 June 1905, which states that a child, a seven year old girl named Dorothy, has “a tendency towards consumption [tuberculosis]” and recommends moving her to the coast. Later correspondence says that she was treated with a special diet including new laid eggs.

Terms like “delicate” and “a tendency to tuberculosis” appear regularly in the case files. The health of the children referred to in this way was not good, but there is evidence to suggest that sending them to the seaside was seen as a preventative measure, stopping the development of more serious problems.

Several case files, such as those quoted above, give the impression that “sea air” was seen as healthy. But a letter from another case file provides a bit more detail. Dated 3 December 1913, it reports on the condition of a 13 year old girl, Annie, who was staying at St. David’s convalescent home in Broadstairs, Kent:

Letter reporting on the condition of Annie, who was staying at St. David’s convalescent home in Broadstairs, Kent, 3 December 1913 (Case number 13819)

Dec. 3rd. 1913.

Dear Sir – I am sorry to
inform you that
Annie [Surname]
has been examined by the
doctor today & he asks me
to write at once to you so
that she may be removed
to a sanitorium [sic] as early
as possible.

Owing to high winds & rain
I was obliged to remove her
bed indoors a fortnight
ago, & since then she has
gone down rapidly &

Dr. Brightman considers
it unsafe for her to be
in a room with other children
owing to her Tubercular

We have no proper place
for out of door patients
in the winter.

I am very sorry indeed
she is such a nice, willing
& gentle child.

Yours faithfully
Elsie Philip-Smith

The most surprising thing about this letter is the time of year it was written. It is implied that the only suitable place to treat tuberculosis patients is outdoors, even in winter. Open-air treatment for conditions including tuberculosis was fairly common a century ago. By arranging beds out in the open, as can be seen in the picture from The Children’s Society’s St Martin’s Home in Pyrford below, patients would be exposed to lots of air.

The open-air ward at St Martin’s Home, Pyrford, Surrey, 1928

From the letter about Annie we discover that open-air treatment was practiced all year-round. The need for weather which allowed it to take place is also evident. It can be said, in fact, that the weather conditions were of greater importance than how close the patients were to the sea. This is certainly suggested by a letter from another case file. A doctor writing in 1909 advises that a girl “threatened with phthisis [tuberculosis]… would be much benefited by removal to a warmer & more equable climate in the South of England.” Since the girl was living at that time in the St Barnabas’ Home For Girls, New Brighton, Cheshire – a place right by the sea – we can say that sea air on its own was not seen as especially important for health.

The prioritisation of fresh air, together with an “equable climate”, features in medical writing from the time. An article in the British Medical Journal from July 1898, for example, advises that an open-air sanatorium for tuberculosis sufferers should be situated “where the prevailing breezes sweep over the sea, or over moorland, or, better still, where these two conditions are associated, and fresh, pure air comes from all quarters of the compass.”

Similar thinking appears in another case file. A doctor’s report from 1927 on a 16 year old boy, Leslie, who had been working at The Children’s Society’s head office in London, states that he is “obviously predisposed to tuberculosis, especially as he works in London”, and recommends for him “an outdoor occupation, preferably in the country or at sea, as this will probably prevent any active tuberculosis developing”. The Society helped Leslie find work as a steward on the SS Baltic. This was quite different to the career previously envisaged for him: earlier correspondence highlights Leslie’s aptitude for draughtsmanship.

This case, like the others, shows the impact contemporary medical opinion had on the lives of children who had tuberculosis or were at risk of contracting it. Nowadays the condition can be treated with antibiotics. But a century ago the dangers were much greater, and the response was often to move children long distances for the good of their health, even if they were only considered susceptible to tuberculosis.

At a time when urban air pollution in Britain was severe, sea air was valued for its quality. However, simply being by the coast was not essential: the objective was fresh air. But the convalescent homes established on the coast did offer other benefits besides sea air. The staff were better trained to look after children with health problems. There were opportunities for the children to get exercise, which may have been limited in more urban homes. There is also evidence in some case files that children were given more or better food to build them up while they were staying in the convalescent homes. Finally, a modern study has suggested that there may be health benefits to be gained from living on the coast, but they are psychological ones, and not related to the air there. The case files show that, in the absence of today’s more effective treatments, a proactive approach to tuberculosis was taken, and this surely saved many lives.

Want to find out more?
Click here to read another blog post on sea air and health, featuring a case where the avoidance of sea air was recommended.

Historic articles from the British Medical Journal discussing open-air treatment of tubercular cases can be found here:

A visit to Westminster Abbey

Here at The Children’s Society Archive we have eight volunteers, and they’ve been a great help in the Unexplored Riches in Medical History project and with other projects at the archive. The time the volunteers give really helps to enrich what we do, so we’re always looking for ways to say thank you. This week, as one way of saying thank you, we took the volunteers on a trip to the archives at Westminster Abbey.

The north front of Westminster Abbey

The Keeper of the Muniments at the Abbey, Matthew Payne, gave us an excellent tour of the library and archives, telling us about their history and the history of the Abbey.

We heard that the library was originally kept in the Abbey cloisters, although most of those early books were dispersed at the dissolution of the monasteries in the 16th Century.

The cloisters in Westminster Abbey

The archives and ‘muniments’, however, have been kept intact, with some of them, and the chests they were stored in, dating back to the earliest days of the Abbey, nearly 1000 years ago. Most of the archives document the work of the Abbey, including records of the work of the monks that used to live at the Abbey, and records of the property and land that the Abbey used to own.

As well as getting to see some of the documents, highlights of the trip included seeing architectural features of the Abbey buildings, particularly in the muniment room. We saw heraldic floor tiles from the 13th Century, ornate, painted ceiling bosses, and a large mural of a white hart, dating back to the time of Richard II.

The west front of Westminster Abbey

All in all it was a fascinating afternoon. Many thanks to Matthew and to Westminster Abbey for allowing us to visit and, of course, many thanks to our volunteers for everything they do.

More information about Westminster Abbey Library and Muniment Room can be found here.

More information about the history of Westminster Abbey can be found here.

A budding artist

Today we have a guest post written by one of our project volunteers, Leonora Fane-Saunders.


Some of the most interesting documents found in the case files are letters written by the children in care to family and friends. They reveal much about life in the homes and about a child’s interests, talents and character.

Edward Gurt was eight years old when an application to The Children’s Society (then the Waifs and Strays Society) was made by Miss Bessie Peacock, the former employer of Edward’s mother. Edward’s father had died, which left his mother struggling to support him.

On the twenty fifth of March 1907 Edward was initially admitted into St Martin’s Home for Crippled Boys, Surbiton, Surrey, due to talipes varus, a congenital deformity of the foot. However, after to a successful operation, Edward was deemed fit for an ordinary home and was transferred first to the Islington Home in London and then to St Michael’s Home in Chislehurst, Kent.

Little is heard about Edward until May 1911 when there is a letter from the head teacher of his school stating that Edward suffered from a heart condition and poor eyesight and would not be allowed to return to school until a doctor pronounced him fit to. As a result Edward was transferred to the Devon House Home in Margate, Kent; this home wasn’t run by The Society, but it specialised in looking after ‘delicate’ children. It was from here that he wrote two very interesting letters to his mother.

Letter from Edward to his mother, 1911 (case number 12589)

Letter from Edward to his mother, 1911 (case number 12589)

July 2nd 1911.

Dear Mother,

I am writing to
tell you that I am getting
used to this new home, here
in Margate. It is a nice
place but I shall be (able) glad
when I can come home and
get some work. I am sorry I
did not write before. How are
Kate, and Harriett getting on.
I don’t suppose you will be able
to come and see me, because
I am too far away from you.
We are having very fine weather
here, and I enjoy myself.

At the Coronation we saw some
races in the park, and at night
when it was getting dark we
saw some fireworks. Please will
you send me six penny stamps.
Last Wednesday the master gave
us all a treat and we had
races and tea up in the field.
Every Saturday we have a
game of cricket.

I remain your
loving Son Edward xxxxx

To Harriett & Kate xxxx xxxx.

Please write soon.

Letter from Edward to his mother, 1911 (case number 12589)

Letter from Edward to his mother, 1911 (case number 12589)

November 12th 1911.

Dear Mother,

I hope you are
still well & happy. I have
not heard from Jack yet
but when I have I will
let you know. If I come
home it will cost 3s 1d
but I shall have to out

how long I can stay. I
shall be glad when I can
come home. Could you send
me some stamps. My stamp-
-album is nearly full. I
have a page of United States,
Austria, France & Germany.
We all had a magic-
lantern last night and

I enjoyed it very much.
I shall be glad when
I can live in London again.
As Jack come home from
Canada yet, or, is (his) he
coming at all. Give my love
to Kate & Harriett. I should
like to see you and Kate
again soon & also Gladys.
I hope Stanley still likes

living in Surrey. I think
I must close now.

I remain your loving
Son Edward xxxx.

These letters reveal a budding artist and avid stamp collector who may be a little home-sick and missing his family. They show he has a tendency to write in dialect: as instead of has. The letters also depict a little of what life was like for Edward and the other boys in the Margate Home. It is clear that sports were encouraged in the form of a weekly cricket game. A picnic and a magic-lantern (an early projection system and forerunner to movies) were provided as treats for the boys. Interestingly, these letters mostly describe special events in Edward’s life, such as the fireworks in celebration of the coronation of King George V.

Sadly due to Edward’s heart condition The Society found it difficult to obtain either training or a job for him. After several fruitless enquiries Edward was eventually returned to his mother in 1912. No further information is given in his file, which leaves us wondering if he ever built up the artistic talent shown in those letters.

Convalescing on the sunny Sussex coast

The Children’s Society has run several children’s convalescent homes over the years. These were homes that specialised in medical care for children and young people. Generally, children were transferred to these homes when they needed more medical care than normal but didn’t need to stay in a hospital. In other cases, the convalescent homes looked after children who had been in hospital for an operation and were now recovering.

One such convalescent home was St John’s Home in Kemp Town, Brighton, Sussex, which was large enough to look after around 80 children. This home wasn’t originally run by The Children’s Society. It was opened in 1875 as an independent home by Sister Jane Borradaile.

The exterior of St John's Convalescent Home, Brighton, taken from the home's 1938 annual report

An annual report from 1937 gives more information about the home:

Built on an ideal site on the Downs about 230ft. above sea level, and yet within ten minutes’ walk of the sea, which is seen from most of the windows; the expansive views of sea, sky and country have a most exhilarating effect, and the result of such an environment is quickly seen in the generally rapid improvement in the health of the patients.

Later, the same report says:

Most of the children who come to us, arrive looking ill and miserable, and it is an unending source of wonder and pleasure to see the often rapid, and generally steady improvement shown after the first few days. Every child is medically examined on admission, and is kept under Medical observation during the whole convalescence. Many grateful letters are received from their parents who often keep in touch with the home for years.

Sister Jane Borradaile died in 1918 and she entrusted the management of the home to the Sisters of the Community of the Holy Cross, Haywards Heath, Sussex. From 1921 onwards the Community appointed Sister Helena Mary to run the home.

In 1938, Sister Helena Mary had to stand down due to health reasons and the Community of the Holy Cross found that they weren’t able to replace her. Instead, the home was transferred to The Children’s Society (then known as the Waifs and Strays Society) as its new trustees.

St John’s Home appeared to have had links to the Waifs and Strays Society for several decades before it came under The Society’s management. Looking through the children’s case files from the Waifs and Strays Society before 1938, we see lots of children being transferred to St John’s Home for treatment when they became unwell.

Once St John’s Home was taken over by its new trustees, things appear to have continued as before, with children staying at the home to recover from operations and medical conditions. There was a brief interlude during the Second World War when the children and staff were evacuated to a building in Itchingfield, Sussex. This evacuated home ran from 1941 to 1945, at which point the home returned to Kemp Town in Brighton.

For over ten more years, St John’s continued as a convalescent home. Then in 1957 it was converted by The Children’s Society into a school for disabled children, with places for 55 children over the age of seven. This school ran for around five years. We don’t know the exact date, but it seems as if the school closed in the early 1960s. All in all, St John’s had looked after children for around 90 years.

The records of St John’s Home and the case files for children staying at the home are a great resource for learning about prevalent medical conditions and medical treatments throughout the course of the home’s lifetime. For example, the annual reports for St John’s Home list all of the conditions that the children in the home were convalescing from that year. The below list of conditions comes from the 1937 annual report and shows that common conditions in the home that year included bronchitis, rheumatism, anaemia and pneumonia (click the image to see a larger version):

List of diseases and operations treated at St John's Home for Convalescent Children, Kemp Town, Brighton, 1937, taken from the annual report for the home

For more information, see the history of St John’s as an independent home and the history of St John’s once taken over by The Children’s Society.

Penny dreadfuls and ‘reading mania’

Is it possible to become ill through reading too much? It’s certainly something that was thought possible in Arthur’s case 114 years ago.

Arthur had been living in Newbury, Berkshire, with his mother and his two younger siblings. His father had died and his mother had run away from an abusive second marriage, leaving her struggling to earn enough money to support the family by herself. We are told that her earnings came from needlework and an occasional lodger.

When Arthur was 14 years old, he was sent to the Workhouse for a fortnight, and from there, in the year 1900, an application was made for Arthur to be taken into the care of The Children’s Society (then known as the Waifs and Strays Society). The reason given for sending Arthur into care is rather unusual. See the application form for yourself:

Application form from case file 7456, stating that Arthur was suffering from 'reading mania', dated 1900

Dear Sir

This boy left school
two years ago & as he was a clever promising boy
some friends helped the mother to apprentice him
to a printer. The work appears to have disagreed
with him, being too confined for his health, he is
a delicate lad & easily led & he has been spending
his master’s time & his own money in buying &
reading a number of penny dreadfuls. By this means
he has quite worried & weakened his brain & he
became so unmanageable three weeks ago that
his mother took him to a doctor, who sent him
to the Workhouse for a fortnight on a cerf certifi
cate as suffering from reading mania. No one can
imagine that there is anything whatever the
matter with the boy’s brain, he answers all questions
most intelligently & as you will see the doctor
who examined him yesterday saw nothing wrong
with him. But he had to be returned home & all
the mischief will begin again unless he is put
under proper control. He ought to have plenty
of fresh air & be carefully controlled & train
ed & I think then he would turn out well.

We are anxious he should be received into
the Hedgerley Farm Home, for which the Guardians
are willing to pay, we have a great opinion of the
training there, as exemplified by a lad from here
who was at Hedgerley for a year & has since done
very well. His mother has been married twice & was oblig
ed to leave her 2nd. husband he became mad & threatened her life &
his own & now she ekes out a spare livelihood for herself & the three
children & she cannot control this big boy of 14

yrs. truly (Miss) Caroline A Talbot ‘Lady Gdns [Guardians]’

I’m sure you’d agree that the main reason given here is a strange one! Nowadays, I doubt anyone would complain that a young person was reading too much. Not only that, but that ‘reading mania’ would be diagnosed by a doctor as a certifiable medical condition seems really quite strange over 100 years later.

An important point to note is that it is not just any books that Arthur was reading but penny dreadfuls. These books were so called because they were cheaply printed and not thought to be very good for the reader. They usually contained sensationalised, escapist stories that were popular with young people like Arthur. The fact that a doctor could diagnose Arthur as suffering from ‘reading mania’ suggests that penny dreadfuls were widespread enough in the early 20th Century to cause general public concern.

If this moral panic at reading sensational stories sounds a little odd to our ears, we could instead try to consider a modern equivalent. Today, for example, there is a lot of concern about video games, particularly violent ones. If a doctor in 2014 certified that a young person was suffering from some sort of mental illness brought on by playing too many violent video games, we wouldn’t necessarily think it was so unusual.

After all this talk of ‘reading mania’, it’s only when we read on to the bottom of the application form that we find what was, most probably, the real reason Arthur needed to be taken into care: his mother was trying to support three children by herself, while earning very little money. If this was the case, then why spend over half the page talking about the penny dreadfuls?

It’s important, when reading this or any document, not just to take it at face value. Instead we need to consider why the document was being written and if the person writing it had an agenda that they wanted to get across. In this case, the form was an application for Arthur to be taken into the care of the Waifs and Strays Society. However, not all applications were successful; the Waifs and Strays Society only had limited funds and so weren’t able to help every child that came to them. Instead, they used the application forms to decide who needed their help the most. In Arthur’s case, we can almost imagine that Miss Talbot, writing the form, was really emphasising the ‘reading mania’ to play on social fears current at the time, which she thought would help to get Arthur accepted into care.

Whether or not the ‘reading mania’ played a large part when Arthur’s case was considered by the Waifs and Strays Society, we don’t know; but we do know that his application was successful. In February 1900, Arthur was admitted into the Hedgerley Farm Home in Buckinghamshire. This home specialised in farming and the boys living there were trained in agricultural skills. Arthur stayed in the Hedgerley Farm Home for one year, after which he returned to his mother.

Overall, the medical diagnosis of ‘reading mania’ probably says far more about the social fears prevalent at the time than it does about Arthur’s health. What are your views on this? If penny dreadfuls were common today, do you think we’d still be worried about young people reading them?

For another example of the public fears surrounding penny dreadfuls and ‘cheap literature’, see this 1895 newspaper cutting at the British Library website.

Tuberculosis in the bones

Today’s case highlights a condition that was fairly common in the late-19th and early-20th centuries, although it’s not very well known today: tuberculosis, but not as you might expect.

It’s easy to think of tuberculosis as purely a lung disease, but in some cases the infection can affect other areas of the body instead. Children’s files in the archive give us examples of tuberculosis in the digestive system, the nervous system, and scrofula (being tuberculosis in the lymph glands in the neck). One of the most common tubercular diseases we’ve found, after tuberculosis in the lungs, is tuberculosis affecting the bones and joints. Often this type of infection occurred after an injury or breakage, with tuberculosis developing in the damaged bone.

Grace was living in Dinas Home For Girls in Brecon, Powys (then in Brecknockshire), when it was taken over by The Children’s Society (then known as the Waifs and Strays Society) in 1909. At this time, Grace would have been 12 years old. She was from London and had entered Dinas home through another charity, the Fulham branch of the Rescue Society, after her parents had separated. Her father had been described as “very unsteady”, with Grace and her three siblings having been neglected when under his care.

While in the Dinas Home, an abscess was found on Grace’s hand, which was identified as being the result of tuberculosis. In early 1911, with Grace around the age of 13, she had an operation to remove the abscess and was then sent to the coast for a month to recuperate. Unfortunately, the operation wasn’t as successful as had been hoped; by December another abscess had appeared on Grace’s wrist.

Grace was seen by a doctor, who recommended that her hand should be bandaged up and that she should be given complete rest and sea air. Because of this recommendation, Grace was sent to The Children’s Society’s new convalescent home, St David’s Home in Broadstairs, Kent.

In St David’s Home, Grace could receive the medical care she needed. Her hand and wrist were treated with poultices and with boracic lotion, which was an antiseptic. Grace was also found to be suffering from head lice, which was treated with sassafras. These treatments seemed to be successful and, in time, the abscess started to clear up and the swelling on Grace’s wrist went down.

After three months in St David’s Home, Grace was transferred to St Audrey’s Home in Bedford. When she arrived at St Audrey’s Home, it was found that Grace was not able to use her hands much. The healed abscess on her right wrist had left it swollen and weak, while the doctor at the home found that she also had a “poisoned” finger on her left hand. After enquiries it was found that just before Grace had left St David’s Home she had pinched her finger in an accident. It was thought that underlying tuberculosis might have caused Grace’s injured finger to go bad.

As it had been discovered that Grace was still suffering from tuberculosis, she quickly returned to St David’s Home in Broadstairs for further treatment.

By September 1912, having been in St David’s Home for a further four months, Grace was described as having put on weight and being in good health. She was now 15 years old and it was thought best to send her to a home where she could start to learn a trade to allow her to go to work when she was well enough.

In October, Grace was sent to St Barnabas’ Home in Newark, Lincolnshire. She didn’t remain in this home for long, however. By January the next year, the doctor at the home had sent on a medical certificate saying that Grace was still suffering from tuberculosis in her wrist, with the disease now in an active state.

And so, in March 1913, Grace was sent to St Anne’s Home in Clapham Park, London, where she could be examined by a doctor. The result of this visit can be seen in the letter below:

Letter from case file 14799, mentioning Grace's visit to a doctor in Harley Street followed by an x-ray at Charing Cross Hospital, 1913

March 28th. 1913

Re Grace [surname]

I took this girl today
to Mr. Boyd, 134 Harley St W, to meet Dr.
Rose Turner there for an interview. Dr. Boyd
sent us to X Ray Dept. Charing X
They gave me no messages (although we
waited for the same) as to when to go
there again, nor whether she was
to be made an in-patient at that

E A Bailey
Travelling Matron W. & S. Society

Dr. Turner has case in
hand. 29.3.13

The x-ray must have shown signs of tuberculosis because it wasn’t long before Grace returned to Charing Cross Hospital to have an operation on her wrist. After this she would need extra medical care while recuperating, but the active condition of the tuberculosis meant that she couldn’t return to St David’s Convalescent Home in Broadstairs where the children there, already ill, might be put at further risk of infection.

Instead, in April 1913, Grace was transferred to the Westminster Union Infirmary in Lincoln’s Inn Fields, London and then to the Strand Union Infirmary in Edmonton, London. Here it is said that Grace was staying in a small ward and that “… the Doctor has ordered her special diet, extra milk &c [etcetera]”. When visited by one of The Children’s Society’s travelling matrons, Grace was found to be doing well, with her wrist weak but healed up.

This is all we hear about Grace until November 1913. By this point we find that she had been transferred to the Isolation Hospital in Ramsgate, Kent, but there are no updates as to her condition. With no further correspondence in Grace’s file, we can only guess at how she was doing. The operation on her wrist may perhaps have healed, but the fact that she was still in hospital suggests that her tuberculosis hadn’t cleared up completely and was potentially still active. The prognosis for Grace, then, didn’t look good, and without the option of the antibiotics we have today, it seems like further surgery may have been Grace’s only hope.

As sad as it is, Grace’s file gives us some interesting information about medical treatments in the early-20th Century. We find out that boracic lotion was used as an antiseptic and that sassafras was used to treat head lice. Not to mention, we have evidence of x-rays being used as a tool for diagnosis, and this only 18 years after x-rays had first been discovered.

Most importantly, Grace’s file shows us what it would have been like to live with a tubercular infection in the joints and bones. This was a disabling condition that left Grace living in convalescent homes and hospitals, unable to continue the training she had started. Even invasive surgical treatment, it seems, wasn’t able to stop the infection fully, leaving potential for the disease to return and spread to other parts of the body.

(For more information about the early use of x-rays, see this page from the British Library.)